• Journal of Families and Better Life
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• v.24 no.1 s.79
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• pp.55-69
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• 2006

This study has been performed to investigate group differences and determining factors of burnout of the workers in elderly living facilities. In this study, 131 male and female workers composed of social workers, health practitioners, and other management workers were selected among 23 retirement and nursing facilities in Korea between 2003 and 2005. They were asked about their socioeconomic background, working environment, and their perceptions on burnout in the working places. As for main dimensions of the burnout, there were three elements such as emotional weariness, diminishing personal accomplishment, and depersonalized behaviors. Particularly in this study, the depersonalized behaviors were defined as aggressive or rude verbal and behavioral outbursts from anger. As a result of this study, the following results were found: Most workers have medium level of perception on their commitment and burnout, but there. are some risk factors; newly married young workers were less satisfied or fairly rewarded with their job and as a result, they have significantly higher level of emotional weariness but lower feeling of personal accomplishments. In addition, they occasionality practiced aggressive or rude behaviors such as yelling, threatening, and physically harassing As for the influence of determining variables, long-time workers of long established facilities were more satisfied and less burnout. In addition, there are some impacts of job category; health practitioners were more burnout than social workers. In this study, suggestions are made as follows: first, guiding and settlement programs should be developed for the newly started young married workers, particularly at early stage of their career. Second, future aspects of facility visions should be guided for the workers, so that they are relieved from stressful routines without any future plan. Third, medical workers such as physical therapists and nurses should be further monitored for main reasons of increasing their stress.

• 재활복지
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• v.21 no.3
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• pp.49-63
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• 2017

The purpose of this study is to investigate the association of functional disability, ego integrity and depressive symptoms, and analyze the mediating effect of ego integrity among the elderly, residing in the long-term care facilities. The data were collected by using non-random purposive and convenient sampling methods and 247 elderly who reside in the nursing home care, located in Daegu city and Kyungpook provinces participated in this study. Findings of this study indicates that there are statistically significant relationships among functional disability, ego integrity and depressive symptoms of participants. In addition, the mediating effect of ego integrity on the relationship between functional disability and depressive symptoms is statistically significant and shows partial mediating effect. Based on the findings of this study, possible practice implications for improving functional and mental health of the elderly in residential care home and recommendation for further study were provided.

• Journal of Families and Better Life
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• v.26 no.5
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• pp.195-209
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• 2008

The purpose of this study was to provide basic information about design guidelines of activity areas in elderly nursing facilities. For the study, the activity areas of 44 facilities in Korea were investigated to categorize their spatial compositions and forms, and then a case study about 19 facilities was conducted to analyse their hierarchical characteristics. The results of the study were as follows: First, the major type of spatial composition among 44 research facilities was concentration, but compartment type was the main among unit-care facilities. By the year, all the types of spatial composition were evenly distributed during recent five years, while concentration type was about 40% before 2003. Second, the major form of activity areas was hall or corridor extension for large group. But there was more alcove or separation form among small group spaces. Third, in the case analysis about hierarchical characteristics, hall and corridor extension form met the requirements of accessibility and openness of public and semi-public areas. On the other hand, separation form had a problem in satisfying both requirements. The semi-private areas, which were around the elderly bedrooms and the elderly were able to watch activities in, were not sufficient in many facilities. Fourth, the division of public and semi-public area was mainly by furniture, and the individuality of semi-private area was defined by dead-end place and corner seats of the window or the corridor. The diversity of semi-private area was likely to be appeared in connection or distribution type. On the basis of the results, the basic design guidelines for activity areas in elderly nursing facilities could be suggested as follows: On the whole, connection or distribution type in spatial composition is more efficient for hierarchical flow than concentration or compartment type is, especially in Korean facilities having many elderly residents per floor. In detail, the design of public and semi-public area should be focused on their openness and accessibility. The recommended forms of activity areas were hall or corridor extension in public area, and living room, corridor extension, or large corridor in semi-public area to effectively function as large or small group spaces. In semi-private areas, the spatial diversity and individuality should be considered.

• Journal of Families and Better Life
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• v.29 no.3
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• pp.23-41
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• 2011

The purpose of this study is to explore social supports for elderly housing and their residential lives in small cities along rural counties of the United States and Canada, and suggest future implications for age-concentrated rural villages in Korea. In this study, five small and medium cities in non-metropolitan counties of California and Ontario province were visited and elderly residents and service experts were interviewed about their perceptions of community integrated social support networks for senior residences. The senior housing complexes were built due to influx of both metropolitan and rural residents seeking warm localities, traffic connections, business purposes in active production areas. and leisure attractions. There are five main social support networks for senior housing issues in these areas. First, the areas are claimed for senior zones and accordingly health industries are encouraged by local authorities. Second, the community is homogeneously constructed as a senior friendly environment and include features such as an RV park and mobile cottages. Third, senior-helping seniors are offered active work through golf-cluster active retirement communities. Fourth, traditional theme production camps are mobilized by the elderly workers. Lastly, an information system is maintained for screening volunteers and for senior abuse prevention. On the other hand, residential lives are occasionally negatively influenced by unbalanced concentrations of elderly facilities such as nursing stations and funeral homes. For the future of Korean rural elderly policies, suggestions are made as follows: first, an integrated urban and rural township that contains attractive places for early retiring people who seek a warm atmosphere in later life needs to be constructed. Second, an integrated model retirement village of urban and rural retirement life needs to be initiated as a measure of evaluating the adaptation process of movers in senior concentrated zones. Third, a cooperation system among governmental ministries needs to be formed with the long- term goal of establishing a traditional rural town of independent housing districts and medical facilities in rural areas. Fourth, productive and active lifestyles need to be maintained as the local community and government develop successful retirement rural villages, by limiting the expansion of nursing related facilities. Finally, generation integrated visiting welfare programs and services need to be further developed for the housing areas especially in the winter, when social integration and activity are relatively low.

• Research in Community and Public Health Nursing
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• v.15 no.4
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• pp.551-565
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• 2004

Purpose: The purpose of this study is to develop a day care center model focused on public health institutions for the elderly residing in their homes. Method: Research design for this study was a mult-level research, which consisted of a related literature review, an Internet search for knowledge of the current situation at home and abroad, on-site interviews, questionnaires collected from a sample of residents in a rural area, and a key-informants approach. Results: 1) The subjects of service - Generalized service should be provided to the elderly, 65 years and older, regardless of their assets. 2) The contents of service - Providing pre-health oriented and post-social welfare service that can integrate and satisfy a wide variety of public health and welfare needs of the elderly would strengthen the health care service of a day care center for the elderly. 3) Delivery system - Basic-level local self-governments should become a central operating body, and establishing a properly adjusted delivery system to a rural area after considering the efficiency and the access of vulnerable rural areas is needed based on modification of 'a Special Law for Agricultural and Fishery Areas' (rural public health center>rural health sub-center ${\rightarrow}$ unified health sub-center ${\rightarrow}$ public health hospital (public health center) ${\rightarrow}$ public welfare office). 4) Facility - Public health facilities such as public health centers and sub-centers should be located in areas that can easily access the facilities. 5) Funding - For day care center for the elderly in local self-government, the central government should modify a relevant implementation of subsidy in and provide some facilities and service regardless of the degree of self reliance of local self-government. 6) Human resources - It is needed to guarantee the period of workers of a day care center for the elderly, at least 3 to 5 years, with considering their specialty on aged care and avoiding circulation based positions. Furthermore, appropriate specially trained personnel such as medical workers and social workers should be placed to take care of both health service and welfare through strengthening of 'rules of law of elderly welfare,' Conclusion: future research is needed to test the model through a demonstration study using a model which may be developed in the future and to standardize the appraisal criteria of people hoping to enter a day care center for the elderly.

• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• Journal of the Korean Institute of Rural Architecture
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• v.17 no.1
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• pp.113-120
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• 2015

In recent years, the population composition of rural area is changing due to the decreasing population growth of the aged with disability and people returning to farming. Since 1970's the rural community facilities have been spreaded out across most rural villages. Although the rural community facilities are the most widely used facilities, the existing facilities are need to be new built or remodeled according to demographic changes, usage of facilities, and environmental condition. Given this reality, the rural community facilities such as village assembly hall and nursing home for senior citizen are not only used for daily life place but also used like co-residence having meals and sleeping together. Therefore the rural community facilities have the potential to become welfare service space for rural elderly people. This research focuses on the current situation of universal design applied community facilities. According to the research, most of the village community facilities were built in the 1990s and 82% of the buildings were more than 15 years old. Furthermore, 45% of the village community facilities more than 15 years old most have a ground floor in masonry structure. The area of the building is 65% less than $100m^2$. The width of the access entrance, the height of the sink, gas safety valve and so forth were relatively well designed. However, the handrail of the entrance, space in front of the toilet bowl, the height difference between the entrance and floor, the installation of the width of the ramp and stair handrail was relatively incomplete. Village community facilities to be built in the future should be universal design fundamentally.

• Health Policy and Management
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• v.8 no.1
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• The Journal of the Convergence on Culture Technology
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• v.7 no.3
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• pp.359-363
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• 2021

The purpose of this study is to investigate the effect of gardening programs using therapeutic gardens on the fall efficacy of the elderly. This study was applied to 31 elderly facility users from April to August 2019 at a nursing home P located in Gyeonggi-do. Among the 31 participants who participated in the program, 16 subjects in the experimental group and 15 subjects in the control group were randomly selected. As for the experimental group program, a fall program consisting of fall education and strength training four times a week and a horticultural occupational program were implemented once a week in a healing garden for a total of 15 weeks. The control group performed fall program for 30 minutes 5 times a week for a total of 15 weeks. The fall efficacy of the tested group increased by 5.50 points from 29points before the program to 34.50points after the program, and statistically significant results were obtained (p=0.000). The control group who only progressed the fall program increased 3.63 points from 28.87points before the trial to 32.50points after the trial, and statistically significant results were obtained (p=0.000). From this result, it can be confirmed that the horticultural program using the treatment garden has the potential as a program related to falls. In the future, various studies are needed so that gardening programs using gardens can be applied to prevent falls of the elderly.